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Anatomy and

Physiology of The
Eyes
Maharani cahyono
Ophthalmology Department
Medical Faculty Diponegoro University

TIK
MAMPU MENJELASKAN STRUKTUR ANATOMI ORBITA,
BULBUS OKULI DAN ORGAN AKSESORIUS SERTA
FUNGSINYA

Eye small very important


function
75% information visual

EYE
Surrounded by orbital
bones
Cushioned by pads of fat
Extraocular muscles help
move the eye in different
directions
Nerve signals that contain
visual information
transmitted through the optic
nerve to the brain

External Anatomy of The Eye

ORBIT
Pyramid 4 dinding
Rim < lingkaran di dlmnya proteksi
Volume (dws) 30 ml 1/5 bl mata, 4/5 jar periokuler
(lemak, otot, syaraf)
Bts anterior: Septum Orbita
Bts sinus: s. frontalis (atas), s. maxillaris (bwh), s.
ethmoidalis & s. sphenoidalis (med)
Ddg med & dsr orbita tipis ruptur herniasi

Orbital Wall
Atap Orbita:
Tlg Frontal klj lakrimal di fossa lacrimalis
Tlg Sphenoid (lesser wing)

Ddg lateral:
Bts dg roof fissura orbital superior
Bag antor tlg Zygomatic strongest

Orbital Wall
Dasar Orbita:
Bts dg lateral fissura orbitalis infor
Lempeng orbital tlg Maxilla blowout fractures
Antor (Rim orbita infor) tlg Maxilla (medial) + tlg
Zygomatic (lateral)
Postor processus orbital tlg Palatina
(triangular)

Ddg Medial:
Tlg ethmoid paper thin ke antor menebal
Tlg sphenoid (body) postor aspect

ORBIT
ORBITAL BONES

Blood Supply
Arteries:
Intracranial Internal Carotid a. 1st branch:
Ophthalmic a. passes beneath &
accompanies N II, branches as:
Central Retinal a. enters the N II, 8 15 mm
behind the globe
Lacrimal a. lacrimal glds
Long & Short postor Ciliary a.
Muscular branches antor Ciliary a.

Blood Supply
Arteries:
Short postor Ciliary a. N II + choroid
Long postor Ciliary a. ciliary body + major
arterial circle* of the iris (anastomose w/
antor Ciliary a.)
Antor Ciliary a. antor sclera, episclera,
limbus, conjunctiva, *
Most antor branches of Ophth a. arterial
arcade of the eyelids

BLOOD SUPPLY
Veins:
Supor & Infor Ophthalmic v.
Vortex v.
Communicate w/ Cavernous sinus & Pterygoid
venous
Drain the skin of the periorbital skin
lethal cavernous sinus thrombosis
(in cellulitis periorbital)

Antor Ciliary v.
Central Retinal v.

Annulus of Zinn

EYE BALL

CONJUNCTIVA
Transparent
Covers postor palp &
antor surface of sclera
Continuous w/:
The lid margin
(mucocutaneous
junc) Palpebral
conj
Fornices (supor &
infor)
The limbus (corneal
epithelium)
Bulbar conj

CONJUNCTIVA
The Conjunctiva:
Palpebral Conj firmly
adherent to the tarsus
Bulbar Conj loosely
attached to Tenons
capsule
Plica / semilunar fold &
caruncle

TENON CAPSULE
Fibrous membrane,
envelopes from limbus
to N II
Limbus Conj, Tenon's,
Episclera fixed together
Posteriorly lies the
sclera, contact w/ orbital
structure & muscle cone

TENON CAPSULE
Pierced by extraocular
tendons reflected
surrounding structure
orbital bone limit extr.oc
muscle Check ligaments
Inferiorly:
thicker
fuses w/ fascia of the
IR m & IO m form
the suspensory
ligaments of the
eyeball (Lockwood
ligament)

SCLERA & EPISCLERA


Fibrous (collagen)
Antor cornea; postor scleral foramen (lamina
cribrosa) pass the axon bundle of the N II
Antor sclera episclera (thin, elastic, blood
vessels)
Inner surface lamina fusca (pigment, outer
layer of suprachoroidal space)

SCLERA & EPISCLERA


Thickness: 0,3 mm (at insertion of muscle)
0,6 mm
Penetrated around the N II:

Short & long postor ciliary arteries


Short & long ciliary nerve

Long postor ciliary a. & long ciliary n.

pass in shallow groove at 3 & 9 oclock


meridians
Vortex veins postor equator, 1 each
quadrant
4 antor ciliary a. & v. penetrate 4 mm
from limbus
Nerve supply: ciliary nerve

CORNEA

Transparant, avascular
Thick : 550 m (central)
vertical : 10.6mm
horizontal : 11.7mm
Nerve supply : V1
Corneal layers :
Epitel
Membr Bowman
Stroma
Membr Descemet
Endotel

UVEAL TRACT
IRIS
Pigmented, Extension of
ciliary body
Dividing the COA & COP
Central round aperture
Pupil balance of
parasympathetic (m.
Sphincter pupillae, N III) &
sympathetic (m. Dilator
pupillae) activity
Blood supply: Major circle of
the iris
Nerve supply (sensory):
Ciliary nerve

CORPUS CILIARIS
Pars plicata ciliary process
aqueous formation

Pars plana (4 mm,


posteriorly)

Epithelium: nonpigmented,
pigmented

Ciliary muscle:

Circular & radial fibers


contract & relax zonular fibers

Longitudinal fibers open


pore of TM

Blood & nerve supply:


= Iris, through Vortex veins
ACCOMODATION

CHOROID

Between sclera retina


Dark brown
Pigmented , vascularized
Nutrision 1/3 outer retina,
vitreus, lens

Choroidal blood vessels:


Chorio-capillaris
fenestrated,
nourishes the outer
neuroretina
Drainage: Vortex veins

Lens
4 mm thick, 9 mm ,
Biconvex, avascular,
colorless, almost completely
transparent
65% water, 35% protein +
trace minerals
Supported by zonule of Zinn
at equator corpus ciliaris
Capsule: semipermeable
membrane
Potassium >> in the lens
Ascorbic, Glutathione

Iridocorneal Angle
Aquous outflow
Junc of peripheral cornea
iris root

Schwalbe line Trabecular


meshwork can.schlemms
- 30 collector channels +
12 aqueous veins
episcleral venous system

Vitreus
Clear, avascular, gelatinous body (99% water, 1%
collagen + hyaluronic acid), 2/3 volume & weight of
the eyeball
Outer surface hyaloid membrane contact w/
postor lens capsule, zonular fibers, pars plana
epithelium, retina, N II head
Vitreous base (attachment): pars plana epithelium
& retina just behind the ora serrata

RETINA
Semitransparent,
multilayered, 2/3 postor inner
aspect of globe
Ora serrata
anterior edge of retina
(ragged edge)
6,5 mm behind SL (temporal),
5,7 mm (nasal)
At the PN II & OS ret & RPE
firmly bound limiting ret
detachment
Thickness: 0,1 mm at OS, 0,56
mm at postor pole

RETINA
Macula:
Postor pole, 5,5 6,0 mm
3 mm center macula lutea
w/ fovea centralis
Xanthophyll >>>,
photoreceptors >>>
1,5 mm center retinal
avascular zone
0,25 mm center foveola
(thinnest part of retina)

RETINA
Blood supply:
Choriocapillaris:
1/3 outer + fovea irreparable damage when RD
Fenestrated
Blood barrier RPE

Central retinal artery


2/3 inner
Nonfenestrated blood retinal barrier

EXTRAOCULAR MUSCLES
INSERTION of RECT
MUSCLES

ACTIONS
MUSCLES
Medial
Rectus

Adduction

Lateral
Rectus

Abduction

Superior
Rectus

Elevation

Intorsion

Adduction

Inferior
Rectus

Depressio
n

Extorsion

Adduction

Oblique
Sup

Intorsion

Depressio
n

Abduction

Oblique
Inf

extorsion

Elevation

Abduction

EXTRAOCULAR MUSCLES
Blood Supply:
Ophthalmic artery (muscular branch)
Also:
Lateral rectus m. Lacrimal artery
Inferior Oblique m. Infraorbital artery
Nerve Supply:
N III SR, MR, IR, IO
N IV SO
N VI LR

OCULAR ADNEXA
EYEBROWS
EYELIDS
APPARATUS LACRIMALIS

OCULAR ADNEXA
EYEBROWS
The folds of thickened
skin
Covered w/ hair
The Glabella
hairless between 2
eyebrows

EYELIDS
Skin Layer
Orbicularis Oculi
Muscle (OOM)
Areolar Tissue
Tarsal Plate
Palpebral Conjunctiva

EYELID
1. Skin Layer:
Thin, loose, elastic
Few hair follicles
NO subcutaneous fat
2. OOM:
Concentric close the lids
Inside the lid: Pretarsal & Preseptal portion
Outside the lid: Spread around the orbital

margin (orbital portion)


Supplied by N VII

EYELI
D
3. Areolar Tissue:

Submuscular communicates w/
aponeurotic layers

4. Tarsal Plate:

Main supporting structure of the lids


dense fibrous & elastic tissue
Lateral & medial attached to orbital
margins by palpebral ligaments
Upper & Lower thin fascia (Orbital
Septum)

5. Palpebral Conjunctiva:
3. Adhere firmly to the tarsal plate

The Lid Margins:


GRAY LINE mucocutaneous junction
Anterior Margin:
Eyelashes upper, upward; lower, downward
Glands of Zeis sebaceous glds at base of
eyelashes
Glands of Moll sweat glds
Posterior Margin:
Small orifices of meibomian / tarsal glds

Lacrimal Punctum:
Medial end of the postor margins

Palpebral Fissure:
Lateral canthus 0,5 cm from orb rim
Medial canthus more elliptic, surround

lacrimal lake:
Lacr caruncle modf. sweat & sebaceous glds
Plica semilunaris 3rd eyelid of lower animal
sp

Epicanthus:
Normal in Asian population & Young infants
Hiding caruncle

Orbital Septum:
Lies between Orb rim & tarsus
Serves as barrier
Pierced by:
the several vessels & nerves (lacrimal,
supra/infratrochlear, supraorbital)
Levator palp superior muscle (LPSM)

Blends w/:
Supor: Tendon of LPSM & supor tarsus
Infor: infor tarsus

Lid Retractors:
Musculofacial complex (striated & smooth

muscles) Opening the eyelids


Upper lid m. Levator Palp Supor, divided
into:
Aponeurosis (antor) elevate antor lamella
Mullers muscle (smooth m. fibers) elevating

postor lamella
inserting supor eyelid into postor surface of OOM
upper lid skin crease

Lower lid m. Rectus Infor


Smooth muscle innervated by sympathetic
nerves
Striated muscle innervated by N III

OCULAR ADNEXA
Blood Supply & Lymphatics:
Arteries:
Lacrimal & Ophthalmic arteries (lat & med

branches) anastomoses: submusc. Areolar


tissue

Veins:
Arranged in pre & post tarsal plexuses
Into Ophthalmic veins
Lymphatics:
Lateral side preauricular & parotid nodes
Medial side submandibular l.n.

OCULAR ADNEXA
The Lacrimal Apparatus:
The lacrimal complex:
The
The
The
The
The

Main Lacrimal glds


Accessory Lacrimal glds
Canaliculi
Lacrimal sac
Nasolacrimal duct

The Main Lacrimal Glands:


Orbital portion:
In the lacrimal fossa
Separated from palp. portion by lateral horn of
m. Levator Palp

Palpebral portion:
Just above the temporal segment of the sup or
conj fornix

Secretory ducts w/ 10 orificies connects orb &


palp portion to the supor conj fornix

The Accessory Lacrimal Glands:


Krause & Wolfring glds subs propria palp
conj

Drainage of tear:
Lacr lake upper/lower puncta canaliculi
lacr sac nasolacr duct meatus nasal
cavity
Mechanism: capillary attraction, gravity,
blinking & pumping action by Horners
muscle

Blood & Lymphatic supply:


Arteries: Lacrimal artery
Veins: joins w/ Ophthalmic vein
Lymph drainage: joins w/ conj lymphatic
preauricular l.n.

Nerve supply:
Sensory: Lacrimal nerve (1st div of N V)
Secretory: Great Petrosal nerve (from supor
salivary nucl)
Sympathetic nerve: accompanying the
Lacrimal artery & nerve

Related Structure:
The medial palpebral ligament connects

the upper & lower tarsal plate to Frontal


process at medial canthus antor to lacr. Sac
Below the ligaments lacr. Sac covered by
few fibers of OOM little resistance
swollen in acute dacryocystitis
The angular vein & artery 8 mm from
medial canthus incision should be 2-3 mm

OPTIC NERVE
The Intra ocular:
1,5 mm

The Intra orbital:


25 30 mm; 3 mm

The Optic Chiasm:


Near the top of sella
tursica
Decussation

The Retrochiasmatic

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